Hypofractionated stereotactic body radiation therapy (SBRT) in pediatric patients: preliminary toxicity results of a national prospective multicenter study

Abstract

Objectives: While hypofractionated stereotactic body radiotherapy (SBRT) has been largely adopted in the adult setting, its use remains limited in pediatric patients. This is due, among other factors, to fear of potential toxicities of hypofractionated regimens at a young age. In this context, we report the preliminary acute (<3 months from SBRT) and middle-term (3-24 months) toxicity results of a national prospective study investigating SBRT in pediatric patients.

Methods: Between 2013 and 2019, 61 patients were included. The first 40 patients (median age: 12 y, range: 3-20) who completed a 2-year-follow-up were included in the present analysis. SBRT was used for treating lung, brain or (para)spinal lesions, either as first irradiation (35%) or in the reirradiation setting (65%).

Results: Acute and middle-term grade ≥2 toxicities occurred in 12.5 and 7.5% of the patients, respectively. No grade ≥4 toxicities occurred. Almost all toxicities occurred in the reirradiation setting.

Conclusion: SBRT showed a favorable safety profile in young patients treated for lung, brain, and (para)spinal lesions.

Advances in knowledge: SBRT appeared to be safe in pediatric patients treated for multiple oncology indications. These results support further evaluation of SBRT, which may have a role to play in this patient population in the future.

Figure 1.

Patients and treatments characteristics *expressed as median and range – Dose was prescribed to the isodose 80%/ N: number of fractions; EPN: ependymoma; ES, Ewing’s sarcoma; NB, neuroblastoma; OS, osteosarcoma; PNET, primitive neuroectodermal tumor; RMS, rhabdomyosarcoma.